DEXA Diagnostics paves the way with cutting-edge mobile BMD screening

As a former health club owner and developer, Kip Russo, President of DEXA Diagnostics in Colorado has watched fitness trends come and go. He had been successfully servicing the area's athletic clubs with a suite of mobile hydrostatic body fat testing laboratories, when he realized that dual x-ray absorptiometry (DXA) could provide a more accurate measure of body composition than hydrostatic weighing.

The more Kip studied, the more he realized that the need for mobile bone mineral density (BMD) testing was far greater than the demand for body mass measurement, and, in his opinion, a better use of the technology. Once he came to that conclusion he moved quickly to develop a mobile DXA screening service. "When I realized that my body fat testing service was limited here in Denver, which is where I chose to live, it was in January. I had the first bus operational nine months later," he said.

Russo spent three to four months of that time researching DXA technology, visiting sites that used bone densitometry systems by different manufacturers, even getting scanned himself. "I wanted to get the latest and the greatest and the best," he said. The best-in-class imaging technology he sought had to be ideally suited for a mobile application. "There are a lot of mobile BMD units out there," he noted, "but most of them are larger than mine. I wanted one that would facilitate patient comfort and still fit into a conventional parking place because I'm going to doctor's offices and parking is always an issue."

In addition to image quality, reporting, and footprint, service and warranty were critical considerations in choosing the best system for what was to become a high traffic practice. The Hologic Discovery W (whole body) bone densitometry system was Kip's choice for the first DEXA Diagnostics custom-built 22-foot mobile BMD unit. The W model accurately scans the spine including instant vertebral and aortic calcification assessment, bilateral hips and the whole body for bone density and body composition.

Kip discovered that Hologic's forward-thinking approach to mobility extended to service when DEXA Diagnostics encountered some surprising technical issues. "We've had some unique issues that turned out it to be altitude related - we're at 6,000 feet," he said. He describes Hologic's service organization to be "absolutely the best of the best. I can't imagine anybody being any better."

After eight months in operation, demand for the mobile screening was so great that DEXA Diagnostics purchased a Discovery SL(supine lateral) for a second van. In addition to whole body capabilities and scanning features, the Discovery SL has the Hologic exclusive rotating C-arm. This feature allows the patient to remain supine for a more precise and comfortable lateral instant vertebral deformity assessment (IVA) of the thoracic and lumbar spine while the machine rotates into position. Ordinarily the patient is rotated into a decubitus position which may cause discomfort or lack a true 90 degree position thereby which affecting scan quality and reproducibility.

"Right now we're operating two units in Denver and both of them are operating at their maximum level," Kip said. The quickness of the SL has added to patient throughput.

The DEXA Diagnostic mobile units currently serve 237 different practices within a 45-minute radius from metro Denver. "Our target markets are the practices that are too small and cannot justify purchasing their own machine. So we fit into that niche of people that send out patients to remote locations for screening yet don't have enough volume to justify purchasing a machine of their own. At the average practice we test 10 to 13 patients in a half a day, which is a lot."

An investment in training helps DEXA Diagnostics insure consistently reproducible test results. "Technologists come and go," Kip pointed out. "A new technologist comes in and positions the patients slightly differently, and you're going to get a slightly different bone mineral density result. We make sure that all of our technologists position the patients exactly the same way, same placement on the table, start the scan at exactly the same position."

DXA Diagnostics' technologists also drive the mobile BMD unit which may seem daunting to some. For radiology technologist Jennifer Pratt, RT, who operates the mobile unit serving Colorado Springs however, driving the van and examining patients is what it's all about. "I love it. I enjoy working with patients. I like operating the Discovery system. And I like being on the road."

Kip believes that patients often neglect preventative health measures like bone density tests because they are perceived as non-life threatening, and that inconvenience can keep patients from getting the tests their doctors order. It's a sad fact that more women die of bone density problems each year than die from breast, uterine and ovarian cancer combined.

"We hear many reasons why patients skip getting DXA exams. They're going to an unfamiliar place, it's slightly intimidating, and the average wait time for most DXA exams is an hour or more." DEXA Diagnostics schedules exams in 15 minute intervals, eliminating lengthy wait times that may occur between tests at busy fixed sites. And, having the unit in close proximity to doctors' offices also helps to increase turnout. "If we have ten patients scheduled, we will typically test nine because there's always someone who cancels. So 40% more patients are getting tested when we bring the van to them than would be tested if the patient had to travel to remote labs and hospitals. That's one of the primary reasons the doctors are choosing to go with us instead of sending the patients out."

Kip has found that mobile screening makes great financial and operational sense for his clients as well. "It's a valuable new income stream. We're providing the technical component of the test, and the doctor is reading the test and billing the insurance company for the read -- which he was unable to do before." Additionally, the physician receives hard copy reports before the van leaves the parking lot, instead of waiting up to ten days for test results.

The demand for screening in the metro Denver area keeps the DEXA Diagnostics vans on the road six days a week including Saturdays.

"We have a half dozen locations that are extremely busy and do not want us to impact their parking lot during the week and put extra patients in their waiting room, although they see the necessity of it," Kip remarked. "So they will book the patients in 15 minute increments on a Saturday when they're closed and the facility will fax us the sign in sheet and patient information on a Friday afternoon. We show up in the parking lot Saturday morning and the patients just walk to the mobile unit at the designated time."

There's no question in Kip Russo's mind that taking a new entrepreneurial avenue was a great idea. "If bone densitometry had been around 30 years ago, that's how long I would have been doing it. I'm enjoying this more than anything I've ever done," he declared.